摘要 :
OBJECTIVE: To examine current health policy in Australia and New Zealand and assess the extent to which the policies equip these countries to meet the challenges associated with increasing rates of multi-morbid chronic illnesses. ...
展开
OBJECTIVE: To examine current health policy in Australia and New Zealand and assess the extent to which the policies equip these countries to meet the challenges associated with increasing rates of multi-morbid chronic illnesses. METHOD: We examined reports from agencies holding data relating to chronic illness in both countries, looking at prevalence trends and the frequency of multiple morbidities being recorded. We undertook content analysis of health policy documents from Australian and New Zealand government agencies. RESULTS: The majority of people with chronic illness have multiple morbidities. Multi-morbid chronic illnesses significantly effect the health of people in both Australia and New Zealand and place substantial demands on the health systems of those countries. These consequences are both predicted to increase dramatically in the near future. Despite this, neither country explicitly acknowledges multi-morbidity as a major factor in their policies addressing chronic illness. CONCLUSION AND IMPLICATION: In addition to considering policy responses to chronic illness, policy makers should explicitly consider policies shaped to address the needs of people with multi-morbid chronic illness.
收起
摘要 :
While attending a gleaming fund-raising dinner for medical research recently, my colleagues and I were challenged by the after-entree speaker to contemplate a world, 50 years hence, full of human body replacements parts, either me...
展开
While attending a gleaming fund-raising dinner for medical research recently, my colleagues and I were challenged by the after-entree speaker to contemplate a world, 50 years hence, full of human body replacements parts, either mechanical or biological. These, the speaker intoned, would enable those then 85 to continue in paid employment, perhaps to pay for the parts. Neither prospect stirred the fairly aged audience greatly. Never mind. Robotic antibodies would seek out and destroy our cancer cells. Little zooming mini-subs would ream out our clogged arteries. This evening was not a time to be worried about global warming or where today's inequalities would lead, through the ravages of war, terror or plague. The potion of technical medical advance intoxicated us all and set our cheeks aglow.
收起
摘要 :
As people age, the saw says, they grow more like themselves. So they do in the face of catastrophe, assuming that they survive. Responses to 9/11 reveal the character of those responding and their established value positions.Toler...
展开
As people age, the saw says, they grow more like themselves. So they do in the face of catastrophe, assuming that they survive. Responses to 9/11 reveal the character of those responding and their established value positions.Tolerant people see 9/11 as a signal for the need for more dialogue between Christians and Muslims; those who handle disasters will call for greater biopreparedness in case of further terrorism with anthrax or smallpox; military powerbrokers may well wish to bomb something.
收起
摘要 :
Background The rate of immediate breast reconstruction (IBR) following mastectomy for breast cancer in Australia is low and varies between regions. To date, no previous Australian studies have examined IBR rates between all hospit...
展开
Background The rate of immediate breast reconstruction (IBR) following mastectomy for breast cancer in Australia is low and varies between regions. To date, no previous Australian studies have examined IBR rates between all hospitals within a particular jurisdiction, despite hospitals being an important known contributor to variation in IBR rates in other countries. Methods We used cross‐classified random‐effects logistic regression models to examine the inter‐hospital variation in IBR rates by using data on 7961 women who underwent therapeutic mastectomy procedures in New South Wales (NSW) between January 2012 and June 2015. We derived IBR rates by patient‐, residential neighbourhood‐ and hospital‐related factors and investigated the underlying drivers for the variation in IBR. Results We estimated the mean IBR rate across all hospitals performing mastectomy to be 17.1% (95% Bayesian credible interval (CrI) 12.1–23.1%) and observed wide inter‐hospital variation in IBR (variance 4.337, CrI 2.634–6.889). Older women, those born in Asian countries (odds ratio (OR) 0.5, CrI 0.4–0.6), residing in neighbourhoods with lower socioeconomic status (OR 0.7, CrI 0.5–0.8 for the most disadvantaged), and who underwent surgery in public hospitals (OR 0.4, CrI 0.1–1.0) were significantly less likely to have IBR. Women residing in non‐metropolitan areas and attending non‐metropolitan hospitals were significantly less likely to undergo IBR than their metropolitan counterparts attending metropolitan hospitals. Conclusion Wide inter‐hospital variation raises concerns about potential inequities in access to IBR services and unmet demand in certain areas of NSW. Explaining the underlying drivers for IBR variation is the first step in identifying policy solutions to redress the issue.
收起
摘要 :
A coherent public health response is critical to successfully addressing a wide range of issues facing society - from avian influenza through to climate change and obesity. Much can be learned from the long and varied history of p...
展开
A coherent public health response is critical to successfully addressing a wide range of issues facing society - from avian influenza through to climate change and obesity. Much can be learned from the long and varied history of public health. From the pioneering work of Ibn Sina to the 'new public health' and recent WHO commission on the social determinants of health, we see that public health has been constantly responsive to emerging concerns. It is also clear that it is not only 'traditional' notions of public health but action from diverse fields has helped to achieve the improvements in health that we now see. However, great inequality in health outcomes remain as we enter the 21st Century. Our challenge as the public health community is to engage diverse groups in advocating not just for health, but also for reductions in poverty and inequality.
收起
摘要 :
The Millennium Development Goals (MDGs), agreed to in 2000 by the global community represent the most significant global development initiative of the past decade. We conducted a survey of Australian medical students to explore th...
展开
The Millennium Development Goals (MDGs), agreed to in 2000 by the global community represent the most significant global development initiative of the past decade. We conducted a survey of Australian medical students to explore their knowledge of the Goals and Australia's international aid program. The results indicated that while students are passionate about eradicating extreme poverty, knowledge of global initiatives such as the MDGs is severely lacking. We call on faculties of medicine to teach students about the MDGs and the role they can play in creating a world without poverty.
收起
摘要 :
Co-production partnerships between policymakers, practitioners, and researchers are designed to facilitate production of relevant and readily usable research in health policy and practice contexts. We describe methodological strat...
展开
Co-production partnerships between policymakers, practitioners, and researchers are designed to facilitate production of relevant and readily usable research in health policy and practice contexts. We describe methodological strategies for in-depth collaborative analysis based on a co-produced ethnography of health promotion practice, involving ethnographic researchers and government-based research partners. We draw on a co-production dialogue to reflect critically on the role and value of co-analyzing research findings using thick ethnographic descriptions. The ambiguity of ethnographic imagery allowed flexibility in interpretation of findings and also generated friction. Specific ethnographic images became focal points for productive friction that crystallized ethical and analytical imperatives underpinning the diverse expertise in the team. To make the most of co-analysis of thick ethnographic descriptions, we assert that friction points must be reflexively considered as key learning opportunities for (a) higher order analysis informed by diverse analytical perspectives and (b) more cohesive and useful interpretations of research findings.
收起
摘要 :
Objective: To examine current health policy in Australia and New Zealand and assess the extent to which the policies equip these countries to meet the challenges associated with increasing rates of multi-morbid chronic illnesses.M...
展开
Objective: To examine current health policy in Australia and New Zealand and assess the extent to which the policies equip these countries to meet the challenges associated with increasing rates of multi-morbid chronic illnesses.Method: We examined reports from agencies holding data relating to chronic illness in both countries, looking at prevalence trends and the frequency of multiple morbidities being recorded. We undertook content analysis of health policy documents from Australian and New Zealand government agencies.Results: The majority of people with chronic illness have multiple morbidities. Multi-morbid chronic illnesses significantly effect the health of people in both Australia and New Zealand and place substantial demands on the health systems of those countries. These consequences are both predicted to increase dramatically in the near future. Despite this, neither country explicitly acknowledges multi-morbidity as a major factor in their policies addressing chronic illness.Conclusion and Implication: In addition to considering policy responses to chronic illness, policy makers should explicitly consider policies shaped to address the needs of people with multi-morbid chronic illness.
收起
摘要 :
BACKGROUND: School absence is associated with lower performance on standardized tests. Children born with orofacial clefts (OFC) are likely to have more absence than children without OFC; however, school absence for children with ...
展开
BACKGROUND: School absence is associated with lower performance on standardized tests. Children born with orofacial clefts (OFC) are likely to have more absence than children without OFC; however, school absence for children with OFC has not been quantified. We aimed to describe school absence and its relationship with school performance for children with and without OFC. METHODS: Population-based record-linked cohort study of children (402 with OFC, 1789 without OFC) enrolled in schools in Western Australia, 2008 to 2012. We compared median school absence rates using Wilcoxon rank tests, and investigated the impact of school absence on standardized scores from reading, numeracy, and writing tests, using multivariable models fitted by generalized estimating equations. RESULTS: In Semester 1, at each primary school year level, children without OFC and children with cleft lip only or cleft palate only had similar median absence rates (approximately 1 week). Children with cleft lip and palate had significantly higher absence rates in Years 4 to 6 (between 1 and 2 weeks). During secondary school, median absence rates were higher (2 weeks) for all children, but not statistically different between children with and without OFC. Higher absence was significantly associated with lower standardized reading, numeracy, and writing scores. However, having a cleft of any type had little influence on the association between absence and test scores. CONCLUSION: School absence affected school performance for all children. Absence did not differentially disadvantage children born with OFC, suggesting current practices to identify and support children with OFC are minimizing effects of their absence on school performance.
收起
原文获取